Chronic total occlusion current techniques and factor related to success and failure

Abstract

Background: Chronic total occlusions (CTOs) of coronary arteries represent a common and significant challenge to interventional cardiology. Medical therapy is often regarded as an adequate long term strategy in the management of these lesions with surgical intervention for refractory symptoms. Extensive collateralisation is used as a marker of distal coronary perfusion, further reinforcing non-invasive strategies. The aim of the study is to determine the impact of lesion age on procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).

Patients and methods: 66 patients with CTO having significant angina or recent acceleration of previously chronic stable angina admitted to National Heart Institute and Zagazig University Hospitals were included. The patients were divided into 3 groups: group 1 (CTO age of > than 3 to 12 months), group 2 (CTO age of 12 to 24 months) and group 3 (CTO age of >24 months). All patients were subjected to Percutaneous Coronary Intervention (PCI) for coronary chronic total occlusion.

Results: There is statistically non-significant relation between the studied groups regarding length of hospital stay. About 73%, 59% and 59% within groups of CTO from 3 to 12 months, 12 to 24 months and >24 months were discharged in the same day. All patients had successful outcome.

Conclusion: Success of CTO - PCI in the current era of new dedicated CTO equipment is unlikely to be affected by CTO lesion age.